This is the first report, to our knowledge, of proliferative macular degeneration developing in the same eye of identical twins. The concept of a familial predisposition in age related macular degeneration is consistent with other known risk factors including race, iris pigmentation, hyperopia and macular drusen which are known to be genetically determined. Monozygotic twins provide ophthalmology with an excellent opportunity to study the hereditary aspects of ocular disease.

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